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Aspirin resistance: disparities and clinical implications
Anita Airee1, Heather M Draper, Shannon W Finks
1University of Tennessee College of Pharmacy, Knoxville Campus, 1924 Alcoa Highway, Knoxville, TN 37920, USA. aairee@utmem.edu
Aspirin resistance, the failure of aspirin to prevent thrombosis, affects various patient groups and is linked to increased adverse events. A clinical consensus on managing aspirin resistance is still needed.
Area of Science:
- Cardiology
- Pharmacology
- Vascular Medicine
Background:
- Aspirin is a cornerstone therapy for preventing thrombosis in vascular disease.
- However, aspirin fails to prevent thrombotic events in a subset of patients, termed 'aspirin resistance'.
- This resistance has significant clinical implications due to widespread aspirin use for primary and secondary prevention.
Purpose of the Study:
- To broadly define aspirin resistance and explore its underlying causes.
- To investigate the clinical implications and disparities in aspirin resistance across different patient populations and conditions.
- To review evidence associating aspirin resistance with adverse events and highlight the lack of clinical consensus.
Main Methods:
- Literature review of clinical trial data and studies on aspirin resistance.
- Analysis of factors influencing aspirin efficacy, including biochemical resistance and disease-related thrombogenicity.
- Examination of disparities in resistance rates among specific demographics and clinical conditions.
Main Results:
- Aspirin resistance is observed in various patient populations, including women, individuals with diabetes mellitus, and heart failure.
- Increased rates of aspirin resistance are noted in cardiovascular and cerebrovascular diseases.
- Studies consistently show aspirin resistance is associated with a higher risk of adverse events, irrespective of study design or measurement methods.
Conclusions:
- Aspirin resistance is a significant clinical concern with demonstrable links to adverse thrombotic events.
- Disparities in aspirin resistance exist across diverse patient groups and clinical contexts.
- There is an urgent need for a consensus on the clinical management of patients exhibiting aspirin resistance.
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